title: Macular micropseudocysts in early stages of diabetic retinopathy.
abstract: OBJECTIVE
  To identify by noninvasive means early retinal abnormalities that may predict diabetic macular edema.
  
  
  METHODS
  The authors analyzed retrospectively data from consecutive patients with Type 1 (n = 16) or Type 2 (n = 23) diabetes who presented for routine follow-up of early retinopathy, had no clinical signs or symptoms of diabetic macular edema, and were evaluated with spectral-domain optical coherence tomography. Age- and gender-matched nondiabetic subjects provided normative data.
  
  
  RESULTS
  Spectral-domain optical coherence tomography revealed in the macular region of diabetic patients small hyporeflective areas (median diameter, 55 μm) contained within discrete retinal layers that we named micropseudocysts (MPCs). Micropseudocysts are associated with vascular leakage. The patients showing MPCs had more frequently systemic hypertension and increased central foveal thickness than those without MPCs. The association with increased central foveal thickness was only in the patients with Type 2 diabetes.
  
  
  CONCLUSIONS
  Macular MPCs in patients with mild diabetic retinopathy appear to reflect leakage and can precede macular thickening. The association of MPCs with increased central foveal thickness in patients with Type 2 diabetes, but not in patients with Type 1 diabetes, points to a greater tendency to retinal fluid accumulation in patients with Type 2 diabetes. Studies in larger cohorts will determine the usefulness of MPCs in strategies to abort diabetic macular edema.
authors.affiliation: Department of Ophthalmology, Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Gemma
authors.initials: G
authors.lastname: Tremolada
authors.forename: Luisa
authors.initials: L
authors.lastname: Pierro
authors.forename: Umberto
authors.initials: U
authors.lastname: de Benedetto
authors.forename: Sergio
authors.initials: S
authors.lastname: Margari
authors.forename: Marco
authors.initials: M
authors.lastname: Gagliardi
authors.forename: Gisella
authors.initials: G
authors.lastname: Maestranzi
authors.forename: Giliola
authors.initials: G
authors.lastname: Calori
authors.forename: Mara
authors.initials: M
authors.lastname: Lorenzi
authors.forename: Rosangela
authors.initials: R
authors.lastname: Lattanzio
mesh_terms: D000328:Adult; D000368:Aged; D003560:Cysts / Q000150:complications / Q000175:diagnosis*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000145:classification / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence